Getting over a negative clinical experience a year and a half ago

[rumwynnieRN]

I think this might be more than the clinical experience -- it might be my entire experience at this particular school that lingers in my head, and I think it's keeping me from really moving forward and doing better than I am now at the program I'm in.

The first program I was in was a start up nursing program. It branched out from another university that had an established nursing program that wanted to expand into surrounding communities. I did okay over the summer semester, but when the fall semester started, everything was decent until clinical in the middle of that semester. My first clinical went without incident, but every clinical afterwards, I cried at all of them. It got to the point where I don't think any of the nurses wanted to even work with me, particularly two nurses on the floor. It started with the second clinical where I "couldn't get my story straight," and the nurse essentially blamed me for not giving my patient his medications. I also got in trouble for not doing a lung assessment properly when my teacher saw me do the "head to toe" on my patient.

I had a small recovery the next day, but the subsequent clinical days after just worsened. I was sent home after my third clinical. Our teachers picked our patients, and had I known who this patient was, I think I would have asked for another patient (he was the father in law of the DON. Yeah, um, when you forget his brief/diaper, it doesn't look good on you at all and any confidence you had/recovered evaporates and there's no recovering). I found out he died a few days later, which my teacher mentioned in front of my then clinical group. It wasn't related to anything I had done, or so my teacher led me to believe. I don't know, and I don't think I can find out. My fourth clinical, while it wasn't terrible, it's not a day you'd like to remember when your medication privileges are taken away because you had trouble unlocking the IV line and the nurse's claim that you "fumbled" with SCDs. We hadn't gone over how to apply SCDs, and I asked for help because I didn't think I was doing it right (it didn't look right). Yes, I know all you do is fasten one side to the other, but I really thought I was missing something. I had a chance at redeeming myself this last semester when I put them on someone during clinical.

I will readily admit I wasn't safe, and me failing was the culmination of my incompetence but not from lack of trying plus a not so helping hand from one nurse and her friend. When this nurse said I told her two different things, I was trying to follow the rules: the rules of the school stated that faculty must be present when you administer medications. I told this to my nurse, but I also mentioned if she couldn't wait, I could give the next scheduled meds. I called my teacher, she came down, nurse was already annoyed I had to call her. My teacher got the meds, but then said I could go with my nurse and left. I told said nurse what my teacher said, but then nurse took the meds and just gave them to the patient. She then turns to my teacher and says I told her two different things and I couldn't get my story straight.

The head to toe assessments? It was my understanding that we were suppose to them on our patients, that our nurses weren't suppose to do them. The nurses still did their assessments, and one of my classmates said there was no point in us doing the assessments if they would do them. I got in trouble for that too -- I shouldn't have listened to my classmate. When I attempted at doing my own assessment, I went to look for a thermometer. I figured a classmate had one, ran into her nurse, and her nurse said, "I'm using it right now." She later told my teacher I asked to use a thermometer that was from an isolation room, which wasn't true. When my teacher asked, I felt like I was pressured into saying "Yeah, I did." I said I did because I had gotten into so much trouble, she wouldn't have believed me. I should mention also about the thermometer, I wasn't asking my classmate's nurse for HER thermometer, I said I was going to ask my classmate if SHE had a thermometer.

When midterms came, my teacher had me feeling slightly better about clinical and ready to care for DON's father in law. I was sent home the next day over the brief and told basically to write a paper over my incompetence. I had stayed up later the night before (like until 11 pm) working on a list in addition to my careplan so I wouldn't "freeze" again. I think that sent my self-esteem to an even lower point.

I should've stood up for myself more, and I should've been a lot more organized than I was then. I tried, rather stringently, to follow the rules, only to have them bite me later. The rules were set by the main campus that was in another city, and while they may have worked very well for the hospitals were they've done clinical, they didn't really work at the hospital where we did clinical. When people ask what happened, I tell them, "I followed the rules and got in trouble." It's only now that I understand flexibility and where to keep your mouth shut and when to speak up more.

I didn't get passed the fundamentals class at the first school. After a semester away from nursing school and then getting into another one closer to home, I've done better with considerable improvement in clinical since the first time, and I just passed MedSurg and Pharm. Despite that and beginning my third semester in the fall, there's that lingering thought that I'll fail terribly and it'll be a repeat of the first program. I've made sure not to make the same mistakes (but I've made other mistakes which I corrected or still correcting), every time there's an opportunity to learn now, I run after the chance, but failure is always in the back of my head (the only "exception" was catheterizing a female. Those models make it look easy until you have to find the hole! I wanted to see someone do it first before I tried on a real person).

Does it get better? Am I dwelling too much on the bad experience? My teachers have talked to me about what I need to work on, I've gotten better at assessing people, I haven't killed anyone, I haven't given anyone an air embolus. I mean, really, how do you build yourself up after the nurse eats you and spits you back out?

[madwife2002, BSN, RN]

Wow there is so much to deal with I dont know where to begin.

Does your current school know about your past experiece?

You may need to be honest with them and discuss your worries and concerns.

You had no support and no proper guidance which is what you need.

As far as head to toe assessment, yes you can do it because you are practicing how to do them but No The RN cannot go by what you say she/he has to do their own assessment regardless of how experienced you are because

1/ You are practicing on her licence

2/ You are not the expert you are a student, so you are not liable when things go wrong the RN is. You can document but the RN always has to sign to say she agrees

3/ What if you miss something

I have supervised hundreds of students, had the priviledge of training some fantastic student nurses but I always double check their assessments as I am the one signing my name and it is my licence on the line. I am the patients advocat so I need to ensure their safety at all times

[Turd Ferguson]

Agreed... in school we did "shadow charting" where we essentially did all of the necessary RN assessments and charting, but the patient's primary RN also charted all they needed to because it is still their patient, their license, their responsibility/accountability.

As far as your fellow student saying that they do not need to do assessments, I couldn't disagree more. Even if another RN is doing assessments and charting them, doing them yourself is great experience in assessment, time management, and charting. Any practice you can get doing assessments should be gladly taken- in my experience assessment skills are one of the weakest areas for a nursing student.

[gentlegiver, ASN, LPN, RN]

I agree with Madwife2002, you definitely did not get the support or guidence you should have had. If you feel like you are starting to feel anxious or overly nervous, take a couple minutes to relax and breath, go talk to your instructor. And never agree that you did or said something that you didn't. Before you enter a room, make sure you have all the tools you will need, BP-cuff, Stethascope, thermometer for your assessment. Make sure your Instructor informed the Nurses that you are not allowed to retrieve or pass meds w/o her being there (unless she gives permission in front of the Nurse). If you run into a procedure you have never done before, step right up and tell them you haven't seen/done it and would appreciate watching them do it so you will know you are doing it right. I had an instructor who insisted I "told stories" how she would have known I haven't a clue as she basically ignored me. She told me I had to be at clinicals on the day of my Mothers funeral or she would fail me from the class, then complained because I was unable to concentrate that night. The woman was a total jerk! But, I perserviered and have now been working for 6 years. You will run into Nurses like those you met in clinicals, not much you can do about thier attitude, but, you can still learn from good Nurses, open up to them, they probably had a bad experience like you and will be willing to help you.

[AOx1]

I am an instructor and if this is the sum total of the information, you need to brush yourself off and carry on. I would no more leave a first semester student with so little guidance as I would leave a baby with a sharp knife and tell it to open a jar of baby food. First semesters are often scared of their own shadow.

That said, continue to address the reasons you stood out. Questions are a good thing. Start with: "based on my understanding of x, would it be correct to..." This can show you are prepared. Realize that some nurses are jerks and hate students, just like some members of every profession are jerks. Address any knowledge gaps, and most of all, develop quiet confidence as you improve. Bullies pick on perceived weakness.

[ErinS, BSN, RN]

Honestly, as a student I am surprised you got in trouble for the things you did. It is very strange that you had so little guidance and then were failed for the things you describe. I encourage you to use this as a learning experience. Nurses are human, and we make mistakes. Now you have faced this and know how to deal with it, move on. By the way, people don't die from having one brief change forgotten.

[apreatyana]

Nursing school is a challenge, and I believe everybody has had bad experiences or a bad instructor. Out of the 4 semester I enjoyed only 1 1/2. Most of the time I felt I could not show any weakness, doubt or sign of tiredness; I could not count on instruction's compassion or understanding, open up or ask for much help. We were expected to be prepared up to the teeth and do all we were expected to do the correct way. Only one nurse, during the 2 years were more willing to be nice and helpful. Beside the nursing school stress and demands many of us go through personal challenges as well and, in many cases, can impact our performance and concentration, and that happened to me also. However, my experience taught me, that I was supposed to put all aside, which was hard for me. But I've persisted and refused to fail the program, I was available to work on everything needed for me to make it. Today, though I know some of the bad experiences and feelings I had still hunt me at times....I will move on doing always my very best. Out of all instructors I had, only 3 showed me what to be a nurse really means. Move on girl!!!

[demylenated, BSN, RN]

You are a STUDENT, and are there to LEARN...

It sounds to me you are afraid of failing and putting way to much pressure on yourself. You will not know everything out of the gate - it is ok to fail... that is how you learn. You, as a student, will not be put into the position where something you do could cost the patient their life - unless you do something outside of you abilities or what you are supposed to do...

Brush it off... give yourself the Ok to learn and SUCCEED!!! Get over your fear of failure, and I think you will do ok. It is good to be scared as a student, but once you get pinned, that is it. You have to hold onto your fears and overcome them...

And never, ever, EVER be afraid to ask for help :)

[notjustanurse]

Failure, or what we perceive as failure is everywhere. Yes, you had a bad clinical experience. You have moved on and are learning from your mistakes. Now is the time to LET IT GO before you become a licensed RN who burns out in a few years. Talk to peer groups and your program's counselor. Really, you need to get a handle on this now.

[rumwynnieRN]

There's a lot more, but those were the big ones in clinical.

Thank you:) It helps when people remind me to get over it, and I find out I'm not crazy with the issues I had.

To my teacher's defense, which I think I thought of more than my own needs, she had never taught before. She was encouraging, but I think her inexperience contributed to a lot of my breakdowns. My first semester clinical instructor knew about this experience after clinical was over. She responded, "That's why you're so reluctant." She shook her head at a lot of the things that happened and told me, "You know, I try to follow my students around. I'll hold your hand if you're scared with medication." A lot of my classmates avoid her and aren't exactly fond of her, but I can't say anything bad about her because she wasn't antagonistic, and was, for the most part, highly supportive.

I know I'll have to speak to the counselor again; I talked to her before clinicals started. It's not something I should be carrying with me. Part of the reason it comes up more so at other than in other places is because my classmates are graduating today, and I half think, "I could've graduated today if only..." I end up rethinking it and saying, "You're much better here, and look at what you've gotten to do as opposed to if you had stayed there."

The other thing that I need validation for (in my head) is I have the ability to care for a patient with an obstructive lung disease, specifically COPD. The patient from my second clinical day had COPD, and after crying on the floor, I've been extremely reluctant to care for anyone dx-ed with COPD. I know it doesn't make sense, and really, I should just get over it and pick a patient with said disease during clinical.

[Bhavana]

Wait, I am confused! All of this happened to you in the first semester? During fundamentals? If so, what a mess. You definitely deserve to still be upset. The whole story is very traumatic. you are not alone, though. It wasn't until the damn 3rd semester that I finally started to feel like I knew what I was doing, and even then it was still scary!

A bad teacher (or nurse) can really break you. I have fumbled with many things, and a compassionate instructor understands that you are new, that even the simplest thing can be much harder when you are nervous, and she/he steps in to help you through it. Confidence building is part of the game, and a good teacher will help you build up your self esteem. I hate those teachers who get a kick out of seeing how much they can freak you out. How they think making a nervous wreck out of a student is conducive to learning, I will never know. I had a few teachers like that myself, and believe me, did a lot of crying. Every day on the way home!! My later clinicals, I had male instructors, and I hate to say this, but they were so much better than the females. More laid back, easier to deal with, not likely to nit pick or get all bent out of shape over little things.

Regardless, you hang in there. You are not the only one who has had stress during clinicals. Just keep learning, stay around positive people, and keep a low profile. Respect those above you, they (unfortunately) have the power to make or break you.

[rumwynnieRN]

Wait, I am confused! All of this happened to you in the first semester? During fundamentals? If so, what a mess. You definitely deserve to still be upset. The whole story is very traumatic. you are not alone, though. It wasn't until the damn 3rd semester that I finally started to feel like I knew what I was doing, and even then it was still scary!

Yes, all of that happened during fundamentals. Half of me thinks I'm masochistic for going back to nursing school; I think anyone else would've said, "Eff this, I'm looking at another profession." I don't regret going back, at least with regards to where I am now.